Lung cancer is one of the most common cancers in India. This has been linked to multiple carcinogens and is mostly associated with smoking, both passive and active Surgery, radiation & chemotherapy are the three modalities commonly used to manage the disease in patients.
There are many types of lung cancers. Lung Cancer is caused by lung cells growing out of control. As the number of cells grow, they form into a tumor. Globally, the incidence of lung cancer is more in men over women, associated with the higher number of men who smoke as compared to the latter
Staging of NSCLC patients is critical as it plays an important
role in the therapeutic decision making process.
Both exposure (environmental or occupational) to particular agents & an individual’s susceptibility to these agents are thought to contribute to one’s risk of developing lung cancer
|Tobacco Usage - Smoking of cigarette & Beedi constitute a significant reason for lung cancer|
|Inorganic arsenic Exposure|
|Exposure to heavy minerals - e.g. Chromium, nickel exposure|
|Vinyl Chloride exposure|
The following are the common symptoms of lung cancer
|Cough that does not go away|
|Wheezing (breathe with a whistling or rattling sound in the chest)|
|Weight loss without any explanation|
|Loss of appetite|
|Blood in urine|
|Streaks of blood in sputum/cough|
|Significant pain in the body without any explanation|
Imaging tools are used to understand the spread , extent and confirm cancer. However, they are not sufficient to confirm malignancy of the disease as both benign and malignant tumors exhibit same behaviour on radiographs.
Hence it is typical for an imaging test to be followed by tests for histological confirmation. Additionally, biomarker tests and biopsy procedures are done to stage the disease/confirm the disease
Common Imaging tests include
A significant percentage of patients with NSCLC are diagnosed at an advanced stage, for which 5-year survival rate is not very high. However, with newer drugs being available, the situation is changing for the better and we are seeing progress in the survival rate among patients
Once the patient is diagnosed with the disease, Surgery, radiation therapy (RT) and chemotherapy are the three modalities commonly used to treat patients with NSCLC
Staging of NSCLC patients is critical as it plays an important role in the therapeutic decision making process. This must be done correctly by consulting with the healthcare provider as this decides the goal and the outcome of the treatment.
No two patients may get the same treatment, however typical treatment for lung cancer includes
Surgery is done on the tumor to treat lung cancer - as a
part of this all or a part of the lung is removed.
|Systemic therapy(Chemotherapy)|| Chemotherapy is a systemic therapy that uses anti-cancer drugs to
kill or stop the growth of cancer cells
|Systemic therapy(Targeted Therapy)||
Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.
These are the latest drugs against cancer and are not yet commercially available in India. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. For example, the PD-1 pathway may be critical in the immune system’s ability to control cancer growth. Blocking this pathway with PD-1 and PD-L1 antibodies has stopped or slowed the growth of NSCLC for some patients.
The following drugs block this pathway:
|External Radiotherapy||External beam is a treatment option that uses localized high
energy radiation beams to eliminate cancer cells and keep them from growing.
|Brachytherapy||Brachytherapy uses a radioactive substance, usually in the form of seeds which are placed directly into or near the cancer which helps to shrink the tumor.|
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